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Author: Sima

Published on Leave a comment on Vitamin D, Breast Cancer, and Melanoma

Two more studies found that higher levels of vitamin D in the blood are associated with better health outcomes - one study found a lower risk of breast cancer, especially among postmenopausal women, and in the other - better outcomes after a metastatic melanoma diagnosis.

The breast cancer study suggested that a fairly high blood level of vitamin D (25(OH)D serum level>38.0 ng/mL) was associated with a lower risk of breast cancer. But overall they found that women supplementing with vitamin D (more than 4 times a week) at any dose had a lower risk of breast cancer over a 5 year period than those not supplementing with vitamin D. From Environmental Health Perspectives:

Serum Vitamin D and Risk of Breast Cancer within Five Years

Vitamin D is an environmental and dietary agent with known anticarcinogenic effects, but protection against breast cancer has not been established. We evaluated the association between baseline serum 25-hydroxyvitamin D [25(OH)D] levels, supplemental vitamin D use, and breast cancer incidence over the subsequent 5 y of follow-up. From 2003-2009, the Sister Study enrolled 50,884 U.S. women 35-74 y old who had a sister with breast cancer but had never had breast cancer themselves. Using liquid chromatography-mass spectrometry, we measured 25(OH)D in serum samples from 1,611 women who later developed breast cancer and from 1,843 randomly selected cohort participants.

We found that 25(OH)D levels were associated with a 21% lower breast cancer hazard (highest versus lowest quartile). Analysis of the first 5 y of follow-up for all 50,884 Sister Study participants showed that self-reported vitamin D supplementation was associated with an 11% lower hazard. These associations were particularly strong among postmenopausal women.

In this cohort of women with elevated risk, high serum 25(OH)D levels and regular vitamin D supplement use were associated with lower rates of incident, postmenopausal breast cancer over 5 y of follow-up. These results may help to establish clinical benchmarks for 25(OH)D levels; in addition, they support the hypothesis that vitamin D supplementation is useful in breast cancer prevention.

The first sentence in the melanoma study lays out what is widely known: "Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma." Studies show that the relationship between vitamin D, sunlight exposure, and melanoma is complicated in a number of ways, including: sun exposure may be associated with increased survival in patients with melanoma. which may mean that vitamin D has a protective role in patients with melanoma. Several studies suggest that vitamin D may delay melanoma recurrence and improve overall prognosis. The study also found that metastatic melanoma patients with vitamin D deficiency who are unable to or don't raise their vitamin D blood levels (25(OH)D3) have a worse outcome compared to those who are are able to markedly increase (by greater than >20 ng/mL) their 25(OH)D3 levels. From Oncotarget:

Vitamin D deficiency is associated with a worse prognosis in metastatic melanoma

Vitamin D deficiency (≤20 ng/mL) is associated with an increased incidence and worse prognosis of various types of cancer including melanoma. A retrospective, single-center study of individuals diagnosed with melanoma from January 2007 through June 2013 who had a vitamin D (25(OH)D3) level measured within one year of diagnosis was performed to determine whether vitamin D deficiency and repletion are associated with melanoma outcome.

A total of 409 individuals diagnosed with histopathology-confirmed melanoma who had an ever measured serum 25(OH)D3 level were identified. 252 individuals with a 25(OH)D3 level recorded within one year after diagnosis were included in the study .... A worse melanoma prognosis was associated with vitamin D deficiency, higher stage, ulceration, and higher mitotic rate. In patients with stage IV metastatic melanoma, vitamin D deficiency was associated with significantly worse melanoma-specific mortality. Patients with metastatic melanoma who were initially vitamin D deficient and subsequently had a decrease or ≤20 ng/mL increase in their 25(OH)D3 concentration had significantly worse outcomes compared to non-deficient patients who had a >20 ng/mL increase. Our results suggest that initial vitamin D deficiency and insufficient repletion is associated with a worse prognosis in patients with metastatic melanoma.

Published on Leave a comment on Which Form of Vitamin D to Take?

I've frequently mentioned that when taking vitamin D supplements, the one to take is vitamin D3, and not D2. Medscape (the medical site) has an article explaining that results of a recent study showed that vitamin D3 is twice as effective as D2 in raising blood levels of vitamin D. The vitamin D3 form is derived from animal products, while vitamin D2 is plant-based. So check any supplements you purchase because many contain the vitamin D2 form of vitamin D.

Of course, sunlight is the best because it has more benefits than vitamin D - such as also having low levels of "blue light" which energizes T cells (which are part of the immune system). From Medscape:

Vitamin D3, Not D2, Is Key to Tackling Vitamin D Deficiency

Vitamin D3 is significantly more effective at raising the serum biological marker of vitamin D status than vitamin D2 when given at standard doses in everyday food and drink, say UK researchers — findings that could have major implications for both current guidelines and the supplement industry.

In a randomized controlled trial of vitamin D supplements, vitamin D3, which is derived from animal products, was associated with significantly higher serum total 25-hydroxyvitamin D [25(OH)D] levels after 12 weeks than vitamin D2, which is plant-based and currently used in the vast majority of vitamin D supplements.

"The importance of vitamin D in our bodies is not to be underestimated, but living in the UK it is very difficult to get sufficient levels from its natural source, the sun, so we know it has to be supplemented through our diet," explained lead author Laura Tripkovic, PhD, department of nutritional sciences, University of Surrey, Guildford, United Kingdom, in a press release.

She added, "Our findings show that vitamin D3 is twice as effective as D2 in raising vitamin D levels in the body, which turns current thinking about the two types of vitamin D on its head." "Those who consume D3 through fish, eggs, or vitamin D3-containing supplements are twice as likely to raise their vitamin D status [compared with those] consuming vitamin D2 rich foods, such as mushrooms, vitamin D2 fortified bread, or vitamin D2 containing supplements, helping to improve their long-term health." [Original study.]

Published on Leave a comment on Is Male Fertility Plunging Downward?

Image result for human sperm, wikipedia The last post discussed the steep ongoing decline in sperm counts and sperm concentration in men from North America, Europe, Australia, and New Zealand. It mentioned a number of environmental causes that could be contributing to this, including the huge increase of chemicals, especially endocrine disruptors (chemicals that disrupt our hormones) over the past few decades.

But another study was also just published that showed (in mice) that effects of chronic exposure to endocrine disrupting chemicals are amplified over 3 generations - and each generation has even lower sperm counts, sperm concentration, and reproductive abnormalities. So each generation gets progressively worse with continued exposure.

As the researchers state: "Our findings suggest that neonatal estrogenic exposure can affect both the reproductive tract and sperm production in exposed males, and exposure effects are exacerbated by exposure spanning multiple generations. Because estrogenic chemicals have become both increasingly common and ubiquitous environmental contaminants in developed countries, the implications for humans are serious. Indeed, it is possible effects are already apparent, with population-based studies from the U.S., Europe, Japan, and China reporting reductions in sperm counts/quality and male fertility within a span of several decades." Yikes...

The World Health Organization (WHO) considers an impairment in ability to fertilize an egg at 40 million sperm per milliliter or below, and the level where WHO considers fertilization unlikely is 15 million sperm per milliliter. This is why the sperm count study discussed in the last post is so frightening: North American, Canadian, Australian, and New Zealand men  whose partners are not yet pregnant nor do they have children (i.e., they are not confirmed fertile men) have experienced a drop in average sperm count of about 50 percent over four decades, to 47 million sperm per milliliter. Niels Skakkebæk, a Danish pediatrician and researcher working on this topic said: "Here in Denmark, there is an epidemic of infertility."and "Most worryingly [in Denmark] is that semen quality is in general so poor that an average young Danish man has much fewer sperm than men had a couple of generations ago, and more than 90 percent of their sperm are abnormal." Uh-oh...What will it take for governments to address this serious issue?

In the meantime, see the last post for some tips on how to reduce your own exposure to endocrine disrupting chemicals. Just note that you can reduce exposure, but you can't totally eliminate exposure. Excerpts from Environmental Health News:

Science: Are we in a male fertility death spiral?

Margaret Atwood's 1985 book, The Handmaid's Tale, played out in a world with declining human births because pollution and sexually transmitted disease were causing sterility. Does fiction anticipate reality? Two new research papers add scientific weight to the possibility that pollution, especially endocrine disrupting chemicals (EDCs), are undermining male fertility.

The first, published Tuesday, is the strongest confirmation yet obtained that human sperm concentration and count are in a long-term decline: more than 50 percent from 1973 to 2013, with no sign that the decline is slowing. "The study is a wakeup that we are in a death spiral of infertility in men," said Frederick vom Saal, Curators’ Distinguished Professor Emeritus of Biological Sciences at the University of Missouri and an expert on endocrine disruption who was not part of either study.

The second study, published last week by different authors, offers a possible explanation. It found that early life exposure of male mouse pups to a model environmental estrogen, ethinyl estradiol, causes mistakes in development in the reproductive tract that will lead to lower sperm counts. According to vom Saal, the second study "provides a mechanistic explanation for a progressive decrease in sperm count over generations." What makes this study unique is that it examined what happened when three successive generations of males were exposed—instead of just looking only at the first. Hunt, in an email, said "we asked a simple question with real-world relevance that had simply never been addressed."

In the real world, since World War II, successive generations of people have been exposed to a growing number and quantity of environmental estrogens—chemicals that behave like the human hormone estrogen. Thousands of papers published in the scientific literature (reviewed here) tie these to a wide array of adverse consequences, including infertility and sperm count decline. This phenomenon—exposure of multiple generations of mammals to endocrine disrupting compounds—had never been studied experimentally, even though that's how humans have experienced EDC exposures for at least the last 70 years. That's almost three generations of human males. Men moving into the age of fatherhood are ground zero for this serial exposure.

So Horan, Hunt and their colleagues at WSU set out to mimic, for the first time, this real-world reality. They discovered that the effects are amplified in successive generations. They observed adverse effects starting in the first generation of mouse lineages where each generation was exposed for a brief period shortly after birth. The impacts worsened in the second generation compared to the first, and by the third generation the scientists were finding animals that could not produce sperm at all. This latter condition was not seen in the first two generations exposed. Details of the experimental results actually suggested that multiple generations of exposure may have increased male sensitivity to the chemical. [Original study.]

Published on Leave a comment on Steep Decline In Sperm Counts In Western Men

Once again a study (this time a review and meta-analysis of other studies) found an alarming and steep decline in sperm counts in men from Western countries over a 40 year period. This steep decline for both sperm concentration (SC) and total sperm count (TSC) is for men in North America, Europe, Australia, and New Zealand. The sperm count and sperm concentration declined 50 to 60% in the period between 1973 to 2011 - with a downward slope showing a decline of -1.4% to -1.6% per year. On the other hand, men from South America, Asia and Africa did not show a decline.

The authors of the study were very concerned over the results showing this decline in Western countries, with no evidence of the decline leveling off. As these declines continue, more and more men will have sperm counts below the point at which they can reproduce. Instead they will be infertile or "sub-fertile" (with a decreased probability of conceiving a child). The threshold level associated with a "decreased monthly probability of conception" is considered to be 40 million/ml.

Shockingly - this study found that in 1973 when Western men who were not selected for fertility, and didn't know their fertility status (e.g., college students, men screened for the military) - the average sperm concentration was 99 million/ml, but by 2011 it was 47.1 million/ml. These men were called "unselected" and are likely to be representative of men in the general population. Men known to be fertile (e.g., had fathered a child) were at 83.8 million/ml in 1976, but were down to 62.0 million/ml in 2011. Both groups had consistent declines year after year.

What about the men from South America, Asia, and Africa? There, studies showed that the "unselected" men (not selected for fertility and who didn't know their fertility status) started out at 72.7 million/ml in 1983, and were at 62.6 million/ml in 2011, while men known to be fertile started out on average at 66.4 million/ml in 1978 and were at 75.7 million/ml in 2011. They did not show the decline of the North American, European, Australian, and New Zealand group of men.

What does this mean? And what is going on? These results go beyond fertility and reproduction. The decline is consistent with other male reproductive health indicators over the last few decades: higher incidence of testicular cancer, higher rates of cryptorchidism, earlier onset of male puberty, and decline in average testosterone levels. Instead, it appears that sperm counts of men are "the canary in the mine" for male health - evidence of harm to men from environmental and lifestyle influences.

These Western developed countries are awash in chemicals and plastics, also with endocrine disruptors (hormone disruptors) in our foods, our personal care products, etc - and so studies find these chemicals in all of us (in varying degrees). Same with flame retardants, pesticides, "scented" products. Exposure to all sorts of environmental pollutants - whether in air, water, soil, our food - such as high levels of aluminum. All of these can have an effect on sperm counts and reproductive health.

And note that chemicals that can depress sperm counts  are also linked to many health problems, including chronic diseases.

What can you do?  You can lower your exposure to many chemicals (e.g., pesticides), plastics, and endocrine disruptors, but you can't avoid them totally. Yes, it'll mean reading labels and ingredient lists on foods, personal care products (such as soaps, shampoo, lotion), and products used in the home. [LIST OF THINGS YOU CAN EASILY DO]

TRY TO AVOID OR LOWER EXPOSURE TO: phthalates, parabens, BPA, BPS, and even BPA-free labeled products (all use similar chemicals), flame-retardants (e.g., in upholstered furniture and rugs), stain-resistant, dirt-resistant, waterproof coatings, Scotchgard, non-stick cookware coatings, dryer sheets, scented products (including scented candles and air fresheners), fragrances, pesticides in the yard and home, and "odor-free", antibacterial, antimicrobial, anti-mildew products. Don't microwave foods in plastic containers (including microwave popcorn bags). 

INSTEAD: Try to eat more organic foods, look for organic or least-toxic Integrated Pest Management (IPM) alternatives for the home and garden. Store foods as much as possible in glass, ceramic, or stainless steel containers. Buy foods, if possible, that are in glass bottles - not cans (all lined with endocrine disrupting chemicals) and not plastic bottles or containers (plastics leach). Some people use water filters because there are so many contaminants in our water, even if they meet federal guidelines on "allowable levels" in the water.

Avoid cigarette smoke or smoking. Try to lose weight if overweight. Open windows now and then in your residence to lower indoor air pollution. The list is long - yes, a lifestyle change! (see posts on ENDOCRINE DISRUPTORS, FLAME RETARDANTS, and PESTICIDES)

From Medical Xpress: Study shows a significant ongoing decline in sperm counts of Western men

In the first systematic review and meta-analysis of trends in sperm count, researchers from the Hebrew University-Hadassah Braun School of Public Health and Community Medicine and the Icahn School of Medicine at Mount Sinai report a significant decline in sperm concentration and total sperm count among men from Western countries.

By screening 7,500 studies and conducting a meta-regression analysis on 185 studies between 1973 and 2011, the researchers found a 52.4 percent decline in sperm concentration, and a 59.3 percent decline in total sperm count, among men from North America, Europe, Australia and New Zealand who were not selected based on their fertility status. In contrast, no significant decline was seen in South America, Asia and Africa, where far fewer studies have been conducted. The study also indicates the rate of decline among Western men is not decreasing: the slope was steep and significant even when analysis was restricted to studies with sample collection between 1996 and 2011.

The findings have important public health implications. First, these data demonstrate that the proportion of men with sperm counts below the threshold for subfertility or infertility is increasing. Moreover, given the findings from recent studies that reduced sperm count is related to increased morbidity and mortality, the ongoing decline points to serious risks to male fertility and health.

"Decreasing sperm count has been of great concern since it was first reported twenty-five years ago. This definitive study shows, for the first time, that this decline is strong and continuing. The fact that the decline is seen in Western countries strongly suggests that chemicals in commerce are playing a causal role in this trend," Dr. Shanna H Swan, a professor in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, New York.

While the current study did not examine causes of the observed declines, sperm count has previously been plausibly associated with environmental and lifestyle influences, including prenatal chemical exposure, adult pesticide exposure, smoking, stress and obesity. Therefore, sperm count may sensitively reflect the impact of the modern environment on male health across the lifespan and serve as a "canary in the coal mine" signaling broader risks to male health. [Original study.]

  Human sperm. Credit: Wikipedia

Published on Leave a comment on CTE Found In Majority Of Former Football Player Donated Brains

Should tackle football continue to be played in its current form? A study with horrifying results that was published this week in the Journal of the American Medical Association raises that question once again.

The study examined 202 brains of people who had formerly played football for varying lengths of time and at varying levels (some who only played pre-high school, some at high school, college level, semi-professional, or Canadian football league). They found the highest percentage of  the degenerative brain disease chronic traumatic encephalopathy (CTE) among former NFL players (110 out of 111 brains). However, the overall incidence of CTE was 87% when looking at all 202 brains.

They also found that the 3 out of 14 former high school players had mild CTE, but the majority of former college, semiprofessional, and professional players had severe CTE.

The one thing to keep in mind is that the study only examined donated brains of former football players  - which means that the family members were concerned about CTE in the former player (perhaps there were symptoms suggestive of CTE). So we don't know the actual percentage of CTE in currently playing and former football players. But studies (here. here, and here) do show damage from hits received during football games and practice at even the grammar and high school level - and the damage can be from subconcussive hits.

But note that concussions and subconcussive hits (head trauma) also occur in other sports, such as soccer. Everyone agrees we need more studies, and we also need to rethink how some games are played in childhood to protect developing brains.

From NPR: Study: CTE Found In Nearly All Donated NFL Player Brains

As the country starts to get back into its most popular professional team sport, there is a reminder of how dangerous football can be. An updated study published Tuesday by the Journal of the American Medical Association on football players and the degenerative brain disease chronic traumatic encephalopathy reveals a striking result among NFL players. ...continue reading "CTE Found In Majority Of Former Football Player Donated Brains"

Published on Leave a comment on Couples Living Together Share Skin Microbes

Did you know that you exchange some skin microbes with the person you live with? A recent study looked at the microbial communities on different regions of the skin of 10 heterosexual couples living together. The researchers found that cohabitation resulted in microbes being shared, but that a person's own microbes were more important, as well as their biological sex and what region of the skin was sampled. In other words - people's microbes look more like their own microbiome than that of their significant other.

Skin is the largest organ of the body, and it is a protective barrier between a person and its environment. The skin contains a diverse microbial community of largely beneficial and benign microorganisms, and also protects the body from microorganisms with the potential to cause disease. Studies show that at least one million microbes (bacteria, fungi, viruses, archaea, etc.) occupy each square centimeter of skin. Humans shed over one million biological particles per hour.

The researchers also found that female skin microbial communities were more diverse than that of males, and that spending more time outdoors, owning pets, and drinking less alcohol (or none) were all associated with higher levels of microbial skin diversity. They found that a person's biological sex could be determined 100% of the time from microbes on the inner thigh skin. The skin of the feet had the most matched microbes among couples - perhaps when they walk barefoot on floors and the shower, they are sharing microbes (from skin particles that had been shed). From Science Daily:

Not under the skin, but on it: Living together brings couples' microbiomes together

Couples who live together share many things: Bedrooms, bathrooms, food, and even bacteria. After analyzing skin microbiomes from cohabitating couples, microbial ecologists at the University of Waterloo, in Canada, found that people who live together significantly influence the microbial communities on each other's skin. The commonalities were strong enough that computer algorithms could identify cohabitating couples with 86 percent accuracy based on skin microbiomes alone, the researchers report this week in mSystems, an open-access journal of the American Society for Microbiology.

However, the researchers also reported that cohabitation is likely less influential on a person's microbial profile than other factors like biological sex and what part of the body is being studied. In addition, the microbial profile from a person's body usually looks more like their own microbiome than like that of their significant other. "You look like yourself more than you look like your partner," says Ashley Ross, who led the study while a graduate student in the lab of Josh Neufeld.

Neufeld and Ross, together with Andrew Doxey, analyzed 330 skin swabs collected from 17 sites on the participants, all of whom were heterosexual and lived in the Waterloo region. Participants self-collected samples with swabs, and sites included the upper eyelids, outer nostrils, inner nostrils, armpits, torso, back, navel, and palms of hands. Neufeld says the study is the first to identify regions of skin with the most similar microbiomes between partners. They found the strongest similarities on partners' feet. "In hindsight, it makes sense," says Neufeld. "You shower and walk on the same floor barefoot. This process likely serves as a form of microbial exchange with your partner, and also with your home itself." 

The analyses revealed stronger correlations in some sites than in others. For example, microbial communities on the inner thigh were more similar among people of the same biological sex than between cohabiting partners. Computer algorithms could differentiate between men and women with 100 percent accuracy by analyzing inner thigh samples alone, suggesting that a person's biological sex can be determined based on that region, but not others. The researchers also found that the microbial profiles of sites on a person's left side -- like hands, eyelids, armpits, or nostrils -- strongly resemble those on their right side. Of all the swab sites, the least microbial diversity was found on either side of the outer nose. [Original study.]

Published on Leave a comment on Throw Out Expired Medicines Or Not?

Image result for pills wikipedia All of us at some point or another have wondered if we can hold on to medicines past their expiration date, or do we need to throw them out? And if they're still good past the expiration date, how much past the expiration date? Well... the investigative journalism site ProPublica has been examining this issue, and they published an article saying researchers and the government find that many medicines may be good for YEARS past the expiration date. Yes - years!

According to people interviewed for the article, there are no documented cases of negative effects from taking expired drugs. However, while most medicines are fairly stable and last past the expiration date (they mention the exception of liquid medicines, the asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine). Not mentioned, but there is also another one that degrades and can cause health problems such as Fanconi Syndrome: tetracycline. But other than those, it looks like many medicines are incredibly stable past the expiration date - especially when stored properly and in the original sealed containers. Do go read the whole article - it's eye-opening. Including the government's "Shelf Life Extension Program". Excerpts from ProPublica:

The Myth of Drug Expiration Dates

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless. But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term “expiration date” was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don’t necessarily mean they’re ineffective immediately after they “expire” — just that there’s no incentive for drugmakers to study whether they could still be usable.

What if the system is destroying drugs that are technically “expired” but could still be safely used? In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers. The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations. “Lo and behold,” Cantrell says, “The active ingredients are pretty darn stable.”

....That raises an even bigger question: If some drugs remain effective well beyond the date on their labels, why hasn’t there been a push to extend their expiration dates? It turns out that the FDA, the agency that helps set the dates, has long known the shelf life of some drugs can be extended, sometimes by years. For decades, the federal government has stockpiled massive stashes of medication, antidotes and vaccines in secure locations throughout the country. The drugs are worth tens of billions of dollars and would provide a first line of defense in case of a large-scale emergency.

Maintaining these stockpiles is expensive. The drugs have to be kept secure and at the proper humidity and temperature so they don’t degrade. Luckily, the country has rarely needed to tap into many of the drugs, but this means they often reach their expiration dates. Though the government requires pharmacies to throw away expired drugs, it doesn’t always follow these instructions itself. Instead, for more than 30 years, it has pulled some medicines and tested their quality.

Once a drug is launched, the makers run tests to ensure it continues to be effective up to its labeled expiration date. Since they are not required to check beyond it, most don’t, largely because regulations make it expensive and time-consuming for manufacturers to extend expiration dates, says Yan Wu, an analytical chemist who is part of a focus group at the American Association of Pharmaceutical Scientists that looks at the long-term stability of drugs. Most companies, she says, would rather sell new drugs and develop additional products. Pharmacists and researchers say there is no economic “win” for drug companies to investigate further. They ring up more sales when medications are tossed as “expired” by hospitals, retail pharmacies and consumers despite retaining their safety and effectiveness.

That being said, it’s an open secret among medical professionals that many drugs maintain their ability to combat ailments well after their labels say they don’t.....In 1986, the Air Force, hoping to save on replacement costs, asked the FDA if certain drugs’ expiration dates could be extended. In response, the FDA and Defense Department created the Shelf Life Extension Program. Each year, drugs from the stockpiles are selected based on their value and pending expiration and analyzed in batches to determine whether their end dates could be safely extended. For several decades, the program has found that the actual shelf life of many drugs is well beyond the original expiration dates.

A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences. Some that failed to hold their potency include the common asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine, the study said. But neither Cantrell nor Dr. Cathleen Clancy, associate medical director of National Capital Poison Center, a nonprofit organization affiliated with the George Washington University Medical Center, had heard of anyone being harmed by any expired drugs. Cantrell says there has been no recorded instance of such harm in medical literature.

Published on Leave a comment on More Concerns With Nanoparticles In Foods

 The use of nanoparticles in foods is increasing every year, but we still know very little about whether they have health risks to humans, especially if one is eating foods with them daily (thus having chronic exposure). The nanoparticles in foods are ingredients so small that they are measured in nanometers or billionths of one meter. The most common nanoingredients are: titanium dioxide, silicon dioxide, and zinc oxide.

Titanium dioxide is typically used as a "food coloring" to make foods whiter or brighter, but it may or may not be listed on the label. In Europe, this food additive is known as E171. Currently there are no restrictions on using titanium diaoxide nanoparticles in food.

Recent search suggests that there may be health effects from the nanoparticles in our food (here and here), thus we should be cautious. Evidence is accumulating that titanium dioxide nanoparticles can have a negative inflammatory effect on the intestinal lining.

Similarly, a new study  looking at both mice and humans suggests that individuals with inflammatory intestinal conditions such as intestinal bowel disease (colitis and Crohn's disease) might have negative health effects from titanium dioxide nanoparticles - that they could worsen intestinal inflammation. Interestingly, the nanoparticles accumulated in spleens of mice used in the study. The researchers also found that levels of titanium were increased in the blood of patients with active colitis. From Science Daily:

Titanium dioxide nanoparticles can exacerbate colitis

Titanium dioxide, one of the most-produced nanoparticles worldwide, is being used increasingly in foodstuffs. When intestinal cells absorb titanium dioxide particles, this leads to increased inflammation and damage to the intestinal mucosa in mice with colitis. Researchers at the University of Zurich recommend that patients with colitis should avoid food containing titanium dioxide particles. The frequency of inflammatory bowel disease like Crohn's disease and ulcerative colitis has been on the rise in many Western countries for decades.... In addition to genetic factors, environmental factors like the Western lifestyle, especially nutrition, play an essential role in the development of these chronic intestinal diseases.

The research of Gerhard Rogler, professor of gastroenterology and hepatology at the University of Zurich, now shows that titanium dioxide nanoparticles can intensify the inflammatory reaction in the bodies of patients with inflammatory intestinal diseases. Titanium dioxide is a white pigment used in medicines, cosmetics and toothpaste and increasingly as food additive E171, for example, in icing, chewing gum or marshmallows. Until now, there have been no restrictions on its use in the food industry.

The scientists led by Gerhard Rogler concentrated their research on a protein complex inside cells: the NLRP3 inflammasome. This protein complex is part of the non-specific immune system, which detects danger signals and then triggers inflammation. If the inflammasome is activated by bacterial components, for example, and the inflammatory reaction plays a vital role in the defense against infective agents. In the same way, NLRP3 can be activated by small inorganic particles -- sometimes with negative consequences: If uric acid crystals form in the cells, for example the inflammation leads to gout.

The research team first studied the effect of inorganic titanium dioxide particles in cell cultures. They were able to show that titanium dioxide can penetrate human intestinal epithelial cells and macrophages and accumulate there. The nanoparticles were detected as danger signals by inflammasomes, which triggered the production of inflammatory messengers. In addition, patients with ulcerative colitis, whose intestinal barrier is disrupted, have an increased concentration of titanium dioxide in their blood. "This shows that these particles can be absorbed from food under certain disease conditions," Rogler says.

In a further step, the scientists orally administered titanium dioxide nanoparticles to mice, which serve as a disease model for inflammatory bowel disease. Here, as well, the particles activated the NLRP3 complex, which led to strong intestinal inflammation and greater damage to the intestinal mucosa in the mice. In addition, titanium dioxide crystals accumulated in the animals' spleens. Whether these findings will be confirmed in humans must now be determined in further studies. "Based on our results," Rogler concludes, "patients with an intestinal barrier dysfunction as found in colitis should abstain from foods containing titanium dioxide."  [Original study.]

Published on Leave a comment on Are Fungi Growing On Your Wallpaper?

Image result for moldy wallpaper How many people know this? That wallpaper could have fungi (mold) living on it, and this fungi can release toxins (mycotoxins) that can pollute the air and sicken people when people inhale the toxins. The releasing of toxins from the fungi (mold) into the air is called aerosolization - and when this indoor air pollution causes people  living or working in the building to become sick, it is called sick building syndrome. This study looked at 3 common indoor fungal species: Penicillium brevicompactum, Aspergillus versicolor, and Stachybotrys chartarum, and the mycotoxins they produce after growing on wallpaper.

Why does fungi grow on some wallpaper?  The researchers write that: "Many fungi can develop on building material in indoor environments if moisture is high enough". So either high humidity in the home (especially when the weather is hot) or water damage can result in mold growth. It is estimated that in Northern Europe and North America about 20 to 40 % of buildings have visible fungal growth on surfaces. How do the mycotoxins get into the air and move around inside the home? Ordinary living, with people moving around rooms, slamming doors, air drafts from opening windows, and ceiling fans all cause "air velocities" that move around the toxins. Please note that we normally breathe in fungi and bacteria, but inhaling an overload of mycotoxins from moldy wallpaper can sicken a person. From News-Medical:

Fungal toxins from wallpaper source of illness says new research

According to a new study, there are several toxins from fungi that could be released into the air indoors and the source could be fungi living in the wall papers. These may lead to serious health problems say researchers. These ordinary fungi that live with the household wallpaper are basically of three types found the study researchers. They can grow and eventually spread to the air. This leads to serious health consequences. These effects of transmission of the airborne fungi and their toxins on human health have not been studied or considered with importance till date say researchers.

The toxins released from the fungi are called mycotoxins. They can pollute the indoor air and lead to indoor air pollution – a condition called sick building syndrome. Sick building syndrome is a condition where the residents start to feel ill according to the time they have spent in a building.... Study co-author Jean-Denis Bailly, a professor of food hygiene at the National Veterinary School of Toulouse in France in a statement explained that these mycotoxins are released from moldy material of growth of the fungi. They are eventually inhaled by the inhabitants of the home. While investigating the quality of air indoors especially at homes that have higher fungal contamination, the indoor air quality also needs to be tested for fungal toxins, he explained.

According to researchers, there has been extensive study of fungal contamination of food. However there has been little work in terms of fungal toxins in air. For this study they looked at three fungi that commonly also contaminated foods - Penicillium brevicompactum, Aspergillus versicolor and Stachybotrys chartarum. A piece of wallpaper was found to be contaminated with these three fungi. A flowing stream of air was allowed over the wallpaper and samples of air of the room were then collected for testing.

On analysis of the indoor air the researchers found that the small particles of dust floating around in the house which could then be inhaled easily, contained toxins from these fungi. Also all fungi did not spread the toxins at the same rates they found. Some spread more toxins than others and this could help researchers to decide on which fungi species to concentrate on in terms of disease prevention they said.

Published on Leave a comment on Common Chemicals Linked to Chronic Diseases

Another study was just published with worrisome findings about phthalates. Phthalates are a group of chemicals used widely in common consumer products such as food packaging, toys, medical devices, medications, and personal care products. They are endocrine disruptors (can interfere with normal hormonal function) and are linked to a number of health problems (here, here, and here).

The study looked at urban Australian men and found that the higher the level of phthalates, the higher the rate of cardiovascular disease, type-2 diabetes, and hypertension. The researchers also found that higher levels of chronic low-grade inflammatory biomarkers (meaning higher levels of low-grade inflammation) was associated with higher levels of phthalates. All these findings confirm what other studies, done in other countries, have found.

Phthalates, which are measured in the urine,  were detected in 99.96% of the 1504 men. Eating a western dietary pattern (fast food, highly processed, low fiber) was also associated with higher phthalate levels.  However, they did not find an association of phthalate levels with asthma and depression. From Science Daily:

Everyday chemicals linked to chronic disease in men

Chemicals found in everyday plastics materials are linked to cardiovascular disease, type-2 diabetes and high blood pressure in men, according to Australian researchers. Researchers from the University of Adelaide and the South Australian Health and Medical Research Institute (SAHMRI) investigated the independent association between chronic diseases among men and concentrations of potentially harmful chemicals known as phthalates.

Phthalates are a group of chemicals widely used in common consumer products, such as food packaging and wrappings, toys, medications, and even medical devices. Researchers found that of the 1500 Australian men tested, phthalates were detected in urine samples of 99.6% of those aged 35 and over. "We found that the prevalence of cardiovascular disease, type-2 diabetes and high blood pressure increased among those men with higher total phthalate levels," says senior author Associate Professor Zumin Shi, from the University of Adelaide's Adelaide Medical School and the Freemasons Foundation Centre for Men's Health, and a member of SAHMRI's Nutrition & Metabolism theme.

"While we still don't understand the exact reasons why phthalates are independently linked to disease, we do know the chemicals impact on the human endocrine system, which controls hormone release that regulate the body's growth, metabolism, and sexual development and function. "In addition to chronic diseases, higher phthalate levels were associated with increased levels of a range of inflammatory biomarkers in the body," he says.

Age and western diets are directly associated with higher concentrations of phthalates. Previous studies have shown that men who ate less fresh fruit and vegetables and more processed and packaged foods, and drank carbonated soft drinks, have higher levels of phthalates in their urine.... Associate Professor Shi says that although the studies were conducted in men, the findings are also likely to be relevant to women. "While further research is required, reducing environmental phthalates exposure where possible, along with the adoption of healthier lifestyles, may help to reduce the risk of chronic disease," he says. [Original study.]